- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,937.15 / $11,711.10 / $20,608.09
| Facility | | $6,937.15 | $11,711.10 | $20,608.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,620.18 / $23,063.52 / $37,555.07
| Facility | | $15,620.18 | $23,063.52 | $37,555.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,310.42 / $10,794.73 / $15,539.47
| Facility | | $6,310.42 | $10,794.73 | $15,539.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,116.90 / $22,116.90 / $25,956.06
| Facility | | $22,116.90 | $22,116.90 | $25,956.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $10,206.08 / $14,578.22
| Facility | | $1,787.00 | $10,206.08 | $14,578.22 |